İnfertil çiftlerde cinsel yaşam ile ilgili araştırmaların sistematik derlemesi

AMAÇ: Bu sistematik derlemede infertilitenin cinsel fonksiyon ve cinsel yaşam üzerine etkilerini inceleyen güncel araştırmaların sonuçlarını değerlendirmek amaçlanmıştır. GEREÇ VE YÖNTEM: Literatür taraması, Pubmed veritabanında 2007– 2019 yılları arasında yayımlanan makaleler araştırılarak yapılmıştır. Tarama “sexuality, infertility”, “sexual function, infertility”, “sexuality, infertile couple” ve “sexual function, infertile couple” anahtar sözcükleri kullanılarak 5–11 Temmuz 2019 tarihleri arasında gerçekleştirilmiştir. İnfertil kadın ve erkeklerin cinsel yaşantılarını ve infertilite cinsellik ilişkisini inceleyen ve dahil etme/dışlama kriterlerine uygun 40 çalışma araştırma kapsamına alınmıştır. “Cinsel benlik kavramı infertil bireylerde ve eşlerinde nasıl etkilenir?”, “İnfertilitenin çiftlerin cinsel ilişkileri üzerinde olumsuz bir etkisi var mı?”, “Cinsel fonksiyon infertiliteden etkileniyor mu?” ve “Cinsel fonksiyon infertilite tedavisinden etkileniyor mu?” soruları değerlendirilmiştir. BULGULAR: İnfertil çiftlerde cinsellik ile ilgili çalışmalar genel olarak tanımlayıcı türde karşılaştırmalı araştırmalar olarak tasarlanmakla birlikte nitel çalışmalar da bulunmaktadır. Çalışmalarda araştırma grubunu genellikle primer ve sekonder infertil kadınlar ve erkekler oluştururken, kontrol grubunu fertil kadınlar ve erkekler oluşturmaktadır. Yapılan çalışmalarda infertil kadın ve erkeklerin fertil bireylerle karşılaştırıldığında cinsel disfonksiyon prevalansının (%17–76) daha fazla olduğu gözlenmiştir. İnfertil kadınların FSFI skorlarının fertil kadınlara göre daha düşük olduğu belirlenmiştir. İnfertil kadınların daha düşük seviyede birleşme ve mastürbasyon oranlarına sahip olduğu ve arzu ve uyarılma skorlarını düşük olduğu saptanmıştır. Zamanlanmış cinsel ilişki ve yardımcı üreme teknikleri gibi terapötik müdahalelerin infertil çiftlerin cinsel memnuniyetini etkilediği yönünde çalışmalar bulunmaktadır. Çiftlerin zamanlanmış cinsel ilişki nedenli spontan cinsel birlikteliğinin azaldığı veya kaybolduğu yönünde sorunlar yaşadığı belirlenmiştir. SONUÇ: Literatür incelemesi sonucunda cinselliğin infertilite ve tedavisinden önemli derecede etkilendiği ve infertil bireylerin cinselliğin istek, uyarılma, orgazm ve ağrı boyutlarında zorluklar yaşadığı belirlenmiştir.

Systematic review of researches related sexual life in infertile couples

OBJECTIVES: In this systematic review, it was aimed to evaluate the results of recent researches that investigating the effects of infertility on sexual function and sexual life. MATERIAL AND METHODS: The literature search was conducted for publications from 2007 to 2019 via the electronic database PubMed. It was conducted on 5–11 July 2019 using the keywords “sexuality, infertility”, “sexual function, infertility”, “sexuality, infertile couple” and “sexual function, infertile couple”. The study included 40 studies investigating the sexual experience of infertile women and men and the relationship between sexuality and infertility according to the inclusion/ exclusion criteria. These researches focus on the questions “How is the concept of sexual self affecting infertile individuals and their partners?”, “Is there a negative effect of infertility on the sexual relations of the couples?”, “Is sexual function affected by infertility?” and “Is sexual function affected by infertility treatment?”. RESULTS: Although sexuality studies in infertile couples are generally designed as descriptive comparative studies, there are qualitative studies. In the studies, primary and secondary infertile women and men constitute the research group, while the control group consists of fertile individuals. Studies have shown that infertile women and men have a higher prevalence of sexual dysfunction (17–76%) compared to fertile individuals. FSFI scores of infertile women were lower than fertile women. It was found that infertile women had low levels of coitus and masturbation rates. There are studies in which therapeutic interventions such as timed intercourse and assisted reproductive techniques affect sexual satisfaction of infertile couples. It was determined that couples had problems that their spontaneous sexual intercourse decreased or disappeared due to timed sexual intercourse. CONCLUSION: As a result of the literature review, sexuality was significantly affected by infertility and its treatment and that infertile individuals had difficulties in sexual desire, arousal, orgasm and pain dimensions.

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